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Unengaged head

The following question was posted on the Overdue page on www.pregnancy.com.auHi Jane, Thanks for the informative article. I am not overdue yet but my doc said that baby is head down and has not engaged and it may take time. I am @38 weeks +1. also my ultrasound says my cervix is 38 and doc, on internal examination said my passage is narrow. What does all this mean? can i have normal delivery. Waiting response & thanks in advance.

How would you feel if your doctor offered you such advise? What implications does the doctors comments have? Any advise for Samta?

I have had many clients whose baby's heads have been not been engaged at 38 weeks. It can happen at any point and sometimes it takes some labour contractions to encourage the baby's head lower.

No assessment in pregnancy (an internal exam, xray or CT scan) is accurate in determining whether or not a woman is able to give birth naturally. In the past women were told there were not able to give birth after such assessments and then they went on to do so without difficulty. Telling a woman that she has a "narrow passage" only causes her to worry unnecessarily.

With my fifth baby, it actually took some contractions to get her to stay "down" and engaged. Up until then, she would drop and then pop back up. I'd waddle like a duck when she was down low, and then I'd lay down for a nap, and when I got up, I'd be walking normally because she would have popped back up. But when I finally went into labour, her head engaged well and I dilated quickly.

I remember my midwife examining me late in pregnancy with my first baby and she said, "you have good bones for having babies". I agree with you, Jane - to tell a mum that her passage is narrow or give her any indication that things may not go normally or easily for her is completley counter productive.

I read a story a few years ago about a woman who was told that she could not have a natural birth. She ended up hiring a midwife and her midwife educated her and told her that she could give birth naturally. She ended up having a very large baby, but she got to labour outside at her home and she gave birth in the comfort of her living room. I can't remember exactly what position she gave birth in, but the position was key. And if I remember correctly, the birth was not quick and easy - she had to work at it (again, baby was big) but she gave birth naturally after her first C-Section and her doctor telling her that she was so small that she would never be able to birth a baby naturally.

I agree with you as well Jane. Telling a mum she has a narrow passage is counterproductive and discouraging. There is no way to tell ahead of time. Women's bodies can do incredible things. Additionally, I've seen many mothers whose baby's heads were not engaged at 38 weeks. This means nothing.

I have heard so many stories of women being told by their OB that they could never birth naturally because they were "too small" or some other such nonsense who went on to have big, healthy babies naturally. I hope that Samta finds the strength to trust in her own body and its amazing abilities and does not let this doctor discourage her!